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Coding for Gyn and Pap Smear Depends on Circumstances and Payer

Published on Wed Aug 04, 2010

Question: What procedure codes should we submit for a gynecology exam and Pap smear?Montana SubscriberAnswer: From a CPT perspective, you do not have a code choice specific to a gynecology exam and collection of a Pap smear specimen. If the exam and specimen collection are problemoriented (i.e., the patient has presented with a chief complaint leading to the exam), then the exam and specimen collection are simply part of the E/M service otherwise reported for the encounter (i.e., 99201-99215, Office or outpatient visit . . .).More typically, a gynecology exam and Pap smear collection are considered a "well-woman exam." In this situation, they should be considered part of and reported with the appropriate preventive medicine visit service (such as 99395, Periodic comprehensive preventive medicine reevaluation and management of an individual . . . ; 18-39 years), since preventive medicine visits include an age and gender appropriate history and exam.Some payers [...]
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